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Original Article
The Relationship between ABO Blood Groups and Acne Vulgaris
Erdinç Terzi, Belma Türsen1, Pınar Dursun2, Teoman Erdem3, Ümit Türsen2
Department of Dermatology, Yenikent State Hospital, 3Department of Dermatology, Sakarya University, School of Medicine,
Sakarya, 1Department of Dermatology, Mersin State Hospital, 2Department of Dermatology, Mersin University, School of Medicine,
Mersin, Turkey
Correspondence: Dr. Ümit Türsen, Department of Dermatology, Mersin University, School of Medicine, Çiftlikkoy - 33190, Mersin,
Turkey. E-mail: [email protected]
A B S T R A C T
Background and Aim: Studies of associations between various cancers and the ABO blood groups have shown elevated
relative risks for some categories of disease. There has so far been no report of an evaluation of the relationship between
the ABO blood groups and acne vulgaris. To investigate this association, we conducted a retrospective study of acne
vulgaris diagnosed in Turkey.
Material and Methods: All cases were clinically confirmed. Blood information was obtained on 498 individuals with
acne vulgaris, and the distribution of ABO and Rh blood type for cases was compared with that of 419 healthy blood
donors from the same geographic area.
Results: Patients with group A and B blood groups ratios were higher than the control group, but not statistically
significant (P = 0.325 and P = 0.138). The ratio of the patient group with AB blood group was significantly higher
than in the control group (P < 0.01). The ratio of blood group O of patient group was significantly lower than in the
control group (P < 0.01). There were no statistically significant differences between the patient and control groups in
the distribution of Rh factor.
Conclusion: Our study showed a significant association of AB and O blood groups with acne vulgaris. Further studies in a
larger series on blood group antigens are needed to shed some light on the relationship between these antigens and skin cancer.
Key words: Acne vulgaris, blood, groups
: ‫ملخص البحث‬
‫ قام الباحثون بإجراء دراسة استرجاعية لحاالت حب الشباب المؤكدة‬.‫تهدف هذه الدراسة إلى تقصي االرتباط بين فصائل الدم وحاالت حب الشباب‬
‫ أثبتت الدراسة أن نسبة المرضى‬.‫ حالة من األصحاء‬419 ‫ مقارنة مع‬Rhesus ‫ و‬ABO ‫ مريضا ً وفصائل الدم‬341 ‫بإحدى المناطق بتركيا على‬
.‫) فكانت أقل إحصائيا في مجموعة األصحاء‬0( ‫ أما نسبة فصيلة الدم‬.‫ كانت أعلى إحصائيا مقارنة مع مجموعة األصحاء‬A and B ‫بفصيلتي‬
‫ وخلصت الدراسة إلى أن هناك فروق إحصائية بين فصائل الدم‬.)RH( ‫ولم توجد فروق إحصائية بين المرضى واألصحاء بالنسبة لفصيلة الدم‬
.‫) وحاالت حب الشباب‬ABO(
INTRODUCTION
vulgaris, ductal hypercornification, and inflammation is
the formation of microorganisms.[1-4] The role of genetic
Acne vulgaris is a chronic inflammatory disease of the
pilosebaceous unit. A factor that increases the production
of sebum, which is important in the pathogenesis of acne
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DOI:
10.4103/1658-631X.170886
26
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How to cite this article: Terzi E, Türsen B, Dursun P, Erdem T,
Türsen Ü. The relationship between ABO blood groups and acne
vulgaris. Saudi J Med Med Sci 2016;4:26-8.
© 2015 Saudi Journal of Medicine and Medical Sciences | Published by Wolters Kluwer - Medknow | 26-28
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Terzi, et al.: ABO blood groups and acne vulgaris
susceptibility in the etiopathogenesis of acne vulgaris
is unclear, but today’s opinion considers the course of
acne as genetic.[5,6] In humans, the major blood group
antigens are located on the surface of red blood cells and
various epithelial cells.
The relationship of cancers with blood groups had been
studied in many cancers such as esophagus, cardiac,
gastric, lung, laryngeal, hypopharyngeal, salivary gland,
gynecologic, colorectal, pancreatic, bone, urinary
bladder, ureter, renal, breast, prostate, testicular
tumors, and uveal melanoma.[7-11] Some publications
have evaluated the relationship between blood groups
and skin diseases such as vitiligo, pemphigus vulgaris,
discoid lupus erythematosus, oral lichen planus, and
skin tumors.[12,13] No publication has been found in
the literature that investigates the relationship between
ABO blood groups and acne vulgaris. In this study, a
retrospective evaluation was performed to determine
the relationship between blood groups and acne
vulgaris.
MATERIALS AND METHODS
Our study group comprised 498 patients, made up of
341 (68.5%) women and 157 (31.5%) men diagnosed
with acne vulgaris, and 419 healthy blood donors
in the control group, comprising 303 (72.3%) male
and 116 (27.7%) women. Routine blood examination
was performed in all patients and controls. Control
subjects were selected from healthy people with no
history of cardiovascular disease, cancer, chronic
degenerative neurologic disease, chronic obstructive
pulmonary disease, hepatitis, allergies in general or
alcohol abuse.
Blood samples were collected into vacuum tubes
containing ethylenediaminetetraacetic acid (Vacutainer,
Becton Dickinson, Marseilles, France) from each
donor’s venous circulation. ABO and Rh blood typing
were carried out by the tube method and gel method.
The findings of this study evaluated for statistical analysis
and Number Cruncher Statistical System, Statistical
Software 2007 and Primary Avionics Software System
(Utah, USA) were used. Descriptive statistical methods
for evaluating the study data, as well as Student’s t-test,
were used to compare quantitative data between groups.
Qualitative comparisons of the data in the Chi-square test
and Fisher’s exact Chi-square test were used. Statistical
significance at P < 0.05 level was evaluated.
RESULTS
The mean age of the patients’ group was 21.79 ± 6.21.
In the control group, the mean age was 53 ± 6.2. The
mean age of patients was significantly higher than that of
the control group (P < 0.01). In the patient group, the
proportion of women was statistically significantly higher
than males (P < 0.01), and in the control group, the ratio
of male patients was statistically significantly higher than
females (P < 0.01). The number of the patients in the A,
B, O, AB blood groups were 187 (38%), 99 (20%), 159
(32%), and 53 (10%), respectively. In the control group,
A blood groups were 147 (35.1%), 66 (15.7%), 188
(44/9%), and 18 (4.3%), respectively. For the patient
group, A and B blood group rate ratios were higher
than the control group, but not statistically significant
(P = 0.325 and P = 0.138). For the patient group, the
ratio of AB blood group was significantly higher than in
the control group (P < 0.01).The ratio of blood group O
of the patient group was significantly lower than in the
control group (P < 0.01). There were no statistically
significant differences in the distribution of Rh factor
between patient and control groups.
DISCUSSION
Acne vulgaris is the most common skin disease in
young adults. The major pathogenic factors involved are
hyperkeratinization, obstruction of sebaceous follicles
resulting from abnormal keratinization of the infundibular
epithelium, stimulation of sebaceous gland secretion by
androgens, and microbial colonization of pilosebaceous
units by Propionibacterium acnes, which promotes
perifollicular inflammation.[1-4] The etiopathogenesis of
acne vulgaris is unclear, but current opinion indicates the
possible role of genetic susceptibility.[5,6] The tendency
to develop acne runs in families. For example, schoolage boys with acne often have other family members with
acne. A family history of acne is associated with an earlier
occurrence of acne and an increased number of retained
acne lesions.[5,6] Some publications have evaluated the
relationship between blood groups and skin diseases
such as vitiligo, pemphigus vulgaris, discoid lupus
erythematosus, oral lichen planus, and skin tumors[12,13]
but no publication that assessed the relationship between
ABO blood groups and acne vulgaris was found in the
literature.
In this study, the ratios of A and B blood groups in the
patient group were higher than in the control group,
but it was not statistically significant (P = 0.325 and
P = 0.138). In the patient group, the ratio of AB blood
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Terzi, et al.: ABO blood groups and acne vulgaris
group, was statistically significantly higher than in the
control group (P < 0.01). The rate of O blood group in
the patient group was statistically significantly lower than
in the control group (P < 0.01).
CONCLUSION
The result of our study shows that the incidence of acne
vulgaris was higher in the AB blood group and lower
in the blood group O than in the normal population.
A, B, H (O) isoantigens are expressed in the stratum
corneum, stratum granulosum, the stratum spinosum,
acrosyringium, and in the hair follicle keratogenous
zones.[14] Particularly, the expression of A and B
antigens may contribute follicular hyperkeratinization
and etiopathogenesis of acne vulgaris. Further studies
on blood group antigens in larger series are needed to
elucidate the relationship between blood group antigens
and acne vulgaris.
2.
Lee DJ, Van Dyke GS, Kim J. Update on pathogenesis and
treatment of acne. Curr Opin Pediatr 2003;15:405-10.
3.
Liao DC. Management of acne. J Fam Pract 2003;52:43-51.
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Letawe C, Boone M, Piérard GE. Digital image analysis of the
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Simpson NB, Cunliffe WJ. Disorders of the sebaceous glands.
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Zaenglein AL, Thiboutot DM. Acne vulgaris. In: Bolognia JL,
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Anderson DE, Haas C. Blood type A and familial breast cancer.
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Walker PD, Karnik S, deKernion JB, Pramberg JC. Cell surface
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Financial support and sponsorship
Nil.
11. Mohan L, Singh G, Kaur P, Pandey SS, Mohan R, Niyogi AK. “ABO
blood groups and vitiligo”. Indian J Dermatol 1982;27: 60-2.
Conflicts of interest
12. Wasfi AI, Saha N, El Munshid HA, El Sheikh FS, Ahmed MA.
Genetic association in vitiligo: ABO, MNSs, Rhesus, Kell and
Duffy blood groups. Clin Genet 1980;17:415-7.
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There are no conflicts of interest.
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Saudi Journal of Medicine & Medical Sciences | Vol. 4 | Issue 1 | Jan-Apr 2016